Takahashi H, Tezuka F, Fujita S, Okabe H
Department of Oral Pathology, Nagasaki University School of Dentistry, Japan.
Anal Cell Pathol. 1995 Dec;9(4):243-56.
A histological investigation of the vascular changes of three major and lingual minor salivary glands in primary Sjögren's syndrome was carried out on eight autopsied Japanese patients. This study compares vascular lesions in salivary glands between one group of four short-term corticosteroid-treated patients (Cases 1, 3, 4 and 7) and the other group of four long-term corticosteroid-treated patients (Cases 2, 5, 6 and 8). We proposed the following five stages for morphogenesis of arteritis; (1) endothelial swelling, (2) thrombosis, (3) fibrinoid degeneration, (4) necrotizing panarteritis and (5) endarteritis obliterans. Endothelial swelling was seen in small-to-large arteries of major salivary glands and the tongue, and this finding was considered as the initial change of vascular lesion. Thrombosis was observed in the small arteries of both organs. Fibrinoid degeneration and necrotizing panarteritis were predominantly localized in small and middle-sized arteries. Endarteritis obliterans was observed in small and large arteries of major and lingual minor salivary glands in primary Sjögren's syndrome. Vascular lesion of this type was common in the four patients who received corticosteroid for more than 12 months. Corticosteroid therapy appears to accelerate the fibrotic change of the vascular wall. Therefore, we suggest that essential vascular lesions of major and lingual minor salivary glands in primary Sjögren's syndrome may include four types (endothelial swelling, thrombosis, fibrinoid degeneration and necrotizing panarteritis), excluding endarteritis obliterans.
对八名日本尸检患者的原发性干燥综合征中三大唾液腺和舌部小唾液腺的血管变化进行了组织学研究。本研究比较了一组四名短期接受皮质类固醇治疗的患者（病例1、3、4和7）与另一组四名长期接受皮质类固醇治疗的患者（病例2、5、6和8）唾液腺中的血管病变。我们提出了动脉炎形态发生的以下五个阶段：（1）内皮肿胀，（2）血栓形成，（3）纤维蛋白样变性，（4）坏死性全动脉炎和（5）闭塞性动脉内膜炎。在大唾液腺和舌部的小到中等大小动脉中均可见内皮肿胀，这一发现被认为是血管病变的初始变化。在两个器官的小动脉中均观察到血栓形成。纤维蛋白样变性和坏死性全动脉炎主要局限于小和中等大小动脉。在原发性干燥综合征的大唾液腺和舌部小唾液腺的小动脉和大动脉中均观察到闭塞性动脉内膜炎。这种类型的血管病变在接受皮质类固醇治疗超过12个月的四名患者中很常见。皮质类固醇治疗似乎会加速血管壁的纤维化变化。因此，我们认为原发性干燥综合征中大唾液腺和舌部小唾液腺的基本血管病变可能包括四种类型（内皮肿胀、血栓形成、纤维蛋白样变性和坏死性全动脉炎），不包括闭塞性动脉内膜炎。
